Advanced stage incurable cancer patients need palliative care-Prof. Maj.Gen. Aslam


Advanced stage incurable cancer patients
need palliative care-Prof. Maj.Gen. Aslam

We have forty paediatric & adult oncologists, 548-cancer beds in
Pakistan and Liver Cancer has increased from 4% in 2000
to 7.3% in 2012 - Prof. Shahryar

Palliative care also provides back up support for
treating physicians - Dr. Riazur Rahman

LAHORE: Majority of the cancer patients which come to seek treatment are at much advanced stage when the disease is incurable, hence they need palliative care. This is a very well developed specialty and discipline of medicine in the developed world but not so in Pakistan. Hence, it is the duty of the public and private sector to join hands to provide palliative care facilities for these cancer patients so that they can live a pain free comfortable life and have dignified death. This was stated by Prof.Maj.Gen. (R) Mohammad Aslam Vice Chancellor of University of Health Sciences. He was speaking at a seminar on Palliative Care for Cancer Patients held at UHS on April 24th 2013.
Earlier in his presentation on Cancer Prof. Shahryar Prof. of Oncology at King Edward Medical University and Chairman of Cancer Research Group of Pakistan said that according to WHO there are ten million new cancer patients in the world every year which will increase to sixteen million by the Year 2020. Almost 80% of these cancer patients will be in developing countries like Pakistan. Eight million of these patients will die every year for want of treatment. Talking about prevalence of cancer in Pakistan, he said that it is estimated that there will be about three hundred thousand cancer patients and 50% of them die every year waiting for proper treatment.
Talking about paediatric oncology Prof.Shaharyar said that we have only 75-beds, six paediatric oncologists and ten junior doctors. One cancer unit in private sector. Hodgkin’s lymphoma, Acute Lymphoblastic Leukemia, retinoblastoma are all curable if detected early and not providing treatment is letting them die. As regards adult cancer, we have 1, 62,000 new cancer cases every year, thirty five oncologists and 473-beds. We have no teaching of medical oncology in the medical colleges. According to Cancer Group of Pakistan studies, Liver Cancer was 4% in 2000 but now our data shows that it has increased to 7.3% and was third leading cancer in adults after head and neck cancer and lung cancer. Almost 70% of our patient’s present late, developed world has early detection programe which we lack. Mammography clinics can send the images at a central place and early detection and screening can be quite cost effective. We have 70-bed cancer ward in Mayo Hospital Lahore most of the patients we admit are refused treatment at other cancer care facilities. There are no palliative care facilities and no Hospice service, no Bone Marrow Transplant and no screening programme at public hospitals. Cancer Care Hospital and Research Center is planning to build a cancer hospital where no one will be refused treatment. We are also planning to organize a workshop on palliative care from December 7-14th 2013 at Lahore. We can help start a certificate course in palliative care for nurses and Diploma in Palliative Care at University of Health Sciences. His message was that we must work for early detection and primary prevention for cancer.
Dr. Riazur Rahman spoke on palliative care and his emphasis was on caring than curing. Almost 80-90% of cancer patients in Pakistan present at stage III and IV. It is a great burden on healthcare. These cancer patients need Tender Loving Care. We must provide them Hospice care at home. They should have pain free cancer death. In the West there are Chairs and departments of palliative care. Terminally ill cancer patients suffer at the hands of quacks, in teaching hospitals, at the hands of religious healers, at the hands of multinational Pharma companies who make available most expensive cancer medications, they suffer at the hands of doctors’ i.e. GPs as well as Specialists who continue to treat terminally ill patients for monetary gains and private hospitals put these terminally ill cancer patients on respirators all dictated by their materialistic approach and attitude. The physicians must know when to stop curative treatment. Cancer care management is a team work wherein surgeons, pathologist, oncologists and palliative physicians play an important role. Palliative care means active total care of terminally ill patients wherein disease has gone beyond curative stage and they still have some time to live. In palliative care unit, Nurse coordinator plays the central role in collaboration with Home Care Programmes, Volunteer Support and Family Physicians.
In Palliative care, these cancer patients need to be provided social, psychosocial, spiritual support besides bereavement care to the families. When the curative care decreases, role of palliative care increases. Palliative care also provides back up support for treating physicians, he added.

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